This blog is dedicated to exploring topics concerning patients' modesty and privacy concerns. It is hoped we can be a reference source of information for patients trying to find their way through a confusing healthcare system full of all kinds of privacy pitfalls. Further discussion of most of these topics can be found on the companion blog.

Friday, January 14, 2011

Unfortunately, I was introduced to your blogs recently. I found a reference to them on Dr. Maurice Bernstein’s bioethics website on the 38th volumeof his thread on patient modesty. It’s the longest running thread on his entire site. You may want to contemplate why that thread has lasted for years, and why so many patients are concerned about modesty and privacy violations they and their loved ones encounter in medicine today.

My introduction to your blog, Juicy Nurse, was “unfortunate” because the poster who introduced it brought me right to your Monday, September 7, 2009 post entitled “Penis!”The poster, who signed it “Anonymous,” wrote this: “Here’s a blog from one of those gender neutral ‘angels sent from God.’ Note not a single comment calls this unprofessional.”

So, what’s the philosophy of your blog, Juicy Nurse? Here’s what you write:

“This blog is designed to give nurses an opportunity to listen to funny, embarrassing, truthful, sad, and happy stories. I plan to talk about things that don’t get discussed! The truth! This is a forum to be honest about the challenges of nursing! God knows we have challenges. Let’s talk about them!”

Yes, Juicy Nurse, let’s talk about the “truth.” (This goes for you, too, Trauma Diva). Here are a few “truths” for you to consider:

1. Your blog, although aimed a nurses, isn’t read by nurses only. It’s read by the whole world. That’s the nature of the “world-wide” web.

2. What’s “funny’ to nurses is not necessarily “funny” to a good number of your patients. Oh, yes. I know. You’ve got to have a sense of humor. That is true. But you need to realize that what’s “funny” in your work place, often depends upon whether your dressed or in a gown, whether you’re in pain or not in pain, whether you’re exposed or covered, whether your laying on the exam table, or standing over it.

3. You want to talk about “things” that don’t get discussed? Okay, then -- Read the rest of this essay.

You extend your philosophy a bit more, Juicy Nurse, with this explanation:

“Let’s Talk Juice! Being a nurse is rewarding…True, but it is also pretty funny, disgusting and really trying at times. Let’s share the stories that we can not share at work, at the dinner table, or with people that are not in health care. Let’s talk about the unspeakable! No judgements (sic.) here! Enjoy!”

If these are stories you can’t talk about at work, what makes you think they’re appropriate here for everyone to read? Here’s another truth: You did actually share your “Penis” story with those not in health care. And many of them didn’t think it enjoyable, entertaining or funny.

By the way, Juicy Nurse. Words have connotations, and I would suggest to you that the title “Juicy Nurse” sets the wrong tone from the beginning. It seems to encompass all the unhealthy stereotypes about naughty nurses that we see in the media.

My introduction to your blog, Trauma Diva, was “unfortunate” because the poster who introduced it brought me right to that wonderful “Trauma pic of the day.” Readers, go to the bottom page of this link. It shows a naked male patient in the ER, his belly opened up completely, his pubic hair and penis clearly visible. The first question that came to my mind: “Did you have the patient’s permission to post this?” I located your apparent answer in another spot on the page It’s titled “Diva Disclaimer” and reads:

“BTW, all posts are HIPAA compliant. Any event, picture, person or thing that resembles real life in any way is a figment of your imagination. All persons, places and events are purely fictional. Yah?”

How respectful of human dignity, patient privacy and modesty! Your philosophy and purpose for your blog? Here’s what you’ve posted:

“Howdy! Step into the nurse’s lounge of a big city ER. Prop your feet up! Talk is cheap. Gossip, great ER stories, and gross trauma pics are always welcome. This is the spot to dish about worthy trauma trash -- actually trash or dish of any kind will do.”

So -- suffering, hurt, patients in pain are “worthy trauma trash,” or “dishes” of any kind? Yes, talk is cheap, and so is your exploitation of human suffering for the entertainment of the public.

You see, Juicy Nurse and Trauma Diva, here’s my problem with what I’ve seen on your blogs: I have I’ve spent considerable time defending nurses against accusations of unprofessional behaviors, accusations that come from men like the one who found your “Penis!” post and called attention to it. Or, like the man, Trauma Diva, who found the photo you posted for public “enjoyment.” Some of these men clearly are misogynists. They neither like nor respect women in general and nurses especially. They’ve been hurt, insulted, embarrassed, humiliated, shamed by female nurses and they’re not in a forgiving mood. There’s probably nothing we can do to change their minds.

But not all of these men are misogynists. Some of them are good men. Men with wives and daughters, mothers and aunts. They respect women. But their unprofessional treatment has alienated them from female nurses in particular and the health care system in general. Now they’re angry. They don’t trust you.

Your reference to African Americans, is particularly offensive if not racist:

“It is true what they say about the black man. I have seen A LOT of black man (sic) penis and it is NEVER small. From the time these penis’s (sic) enter the world they are HUGE. It is UNBELIEVABLE! The little black babies have penis’s (sic) that actually flop up over their belly buttons. When I worked in pediatrics, I was shocked at the head start that these little black babies get…they are ahead of the game from day 1!”

I do want to apologize to my readers for even quoting this offensive nonsense -- but some of you won’t bother reading the penis article or looking at this blog (I don‘t blame you), so this at least gives you an idea of this kind of disrespectful, shall we also say racist, misandry.

And you, Trauma Diva, with your wonderful, exploitative photo. Is it any accident that you selected a male for this photo? Would you have selected a female with her breasts and genitals showing? Perhaps. Bad judgments goes both ways gender-wise. But many men see a double standard here. Are they wrong?

Can you imagine how people would react if a male nurse wrote a piece like yours, Juicy Nurse, about the various breasts he encountered? How about a male nurse writing about all the different kinds of vulvas and vaginas he encounters every day. Take the quote I provided above -- you know, the different kinds of penises -- and replace penis with vagina or breast. I would suggest that this would never be accepted.

That brings up the double standard regarding how respect for men and men’s modesty is treated by a significant number of medical professionals. As an example, I refer you to web column by a Dr. Sharon Orange called “The 10 Real Reasons Why Men Don’t Go to the Doctor.”

A significant number of men found her tone and language offensive, patronizing. They wondered how it would have been taken if a male doctor had spoken to female patients using that kind of language to describe their private areas. Sexist? Some suggested that any male doctor who wrote like that to women would find his license and/or job in danger.

The irony -- I’m sure Dr. Orange wants to help men. I don’t think she was meaning to be offensive. She exercised poor judgment, stereotyping men, perhaps, believing that by entering into the old boys’ club and using this kind of language she’d score points. One needs to be careful.

Juicy Nurse and Trauma Diva -- Do you see what I’m talking about?

I must say this to my readers. This material is so offensive that it’s hard to be positive that it’s authentic. Are these real nurses writing these blogs, or is this a sad joke? I’ve read everything on both blogs, and it’s clear to me that these are real nurses. All the posts are not like this. Some are actually decent. I’ve run these blogs by other medical professionals who agree that they are authentic. I'm convinced that Juice Nurse and Trauma Diva are real nurses.

Now, Juicy Nurse and Trauma Diva, I challenge you to respond to this post. I’ve read both of your blogs, all the way through -- not just the offensive material. There’s good and bad there. The sad thing about all of this is that I can see that in many ways you’re both kind, caring individuals. I’m also sure you probably have fine skills as nurses. But I question your judgment.

The spider that prowls the world wide web has captured you, wound you up, stung you, and put you to sleep. You think you’re in your own little world rather than exposing yourself to the whole wide world. You’ve forgotten what it means to be on the other side of the gown. You’ve lost your empathy.

I spent a long time writing this piece, and made sure I ran it by my co-moderator, Dr. Joel Sherman. It’s not pleasant for me to attack two nurses. If you read my many, many posts and articles over the years, you’ll see that I have great respect for the vast majority of nurses. But too many today are getting trapped by their Facebook pages and blogs like yours. I don’t think you realize the damage you can do to your profession with some of the posts you write. I don't think you realize how quickly you can alienate your patients with blogs like yours.

NOTE -- Readers: If you, too, are offended by these blogs, consider filing a complaint with the American Nurses Association. Email to ethics@ana.org.

NOTE 2 -- "Apparently," and I use this word for a reason, the real person behind Trauma Diva is this person. On the Trauma Diva blog, under Sunday, April 18, 2010, you'll find at post titled "Writer Out of the Closet" where she gives sends readers to the link above. So, she isn't hiding. She has identified herself. She also

started a amateur radio talk show about popular culture, TV trash and trauma cases. The first, and perhaps the only episode, can be found here. It's mostly dedicated to a shallow discussion of an episode of the reality show, The Bachelor. One caller participated in the show. Near the end, she says future shows will include trauma cases, all of which will be HIPAA compliant, she says.

I mention all this because this nurse is right out in the open. Although she uses the title Trauma Diva, she has made her identity known. I have to give her credit for that. But I see no educational or professional purpose to either her blog or her radio show. It's all about gossip, popular culture, and trash TV. And by mixing in trauma cases with all this, she denigrates the patient experience and patient dignity.

From what I've been able to determine is that corytraumarn isin Nashville Tenn. Vanderbilt Univ. Hosp. I dohave paperwork ready to submit asa hipaa complaint. Now,some may saywell is it a hipaa violation oris it not. One thing is for certain. There is no way this patient pictured could have given permissionto be photographed. It may have been taken as a documentation or for legalmatters,however,it never should havebeen placed on the web.

Doug, great, great letter. I am definitely going to write a complaint letter. Thanks for taking the time to address both of those blogs and for giving your readers a way to respond. And, I firmly believe in God's justice, if not in this world then in the next. "What goes around comes around" and someday these nurses will themselves be patients and will finally "get it." Shame on them.

I've noticed that two comments on "Trauma Diva's" blog entries say "Comment deleted. This post has been removed by the author."

She is already censoring comments she doesn't like, so I imagine she won't allow any comments from anyone opposed to her disgusting attitude. She won't have the guts to respond here (yes that is a challenge).

I've added a note to this article. Apparently, the author of Trauma Diva has identified herself. She came out of the closet in one of her posts that I had missed. You'll find the info at the end of the above article.

On Trauma Diva's blog it says "and gross trauma pics are always welcome" so it could be that she didn't take this picture, perhaps it was sent to her. But you would think she would blur the genitals. Nope guess not, its just another body part to them like a nose, seen a million of them. Do some ERs treat people's modesty the same as farm animals at the vet?

I was wondering if you have received any comments to date from the two blogs mentioned here. I am not asking you to break any confidentiality, just curious as to whether they have even acknowledged our collective concerns.Their silence seems deafening.

As a woman, I've always felt the comfort of nurses of my gender. To think that men don't have the choice of that same benefit is sad. When I read about nurses that mock and joke about their male patients, it sickens me. They are unworthy of nursing anyone at all in my opinion and should be banned.

I'm curious if anyone's submitted a complaint to the Texas BON. It's not only a violation of HIPAA (she gives more than enough info about the coach), it's a violation of state statutes regarding behavior that "constitutes abuse, exploitation, fraud, or a violation of professional boundaries".

Introduction & Welcome

This blog has been created to complement my existing blog on patient privacy. That blog has been organized around comments rather than articles. But as there are now thousands of comments, it is difficult for any new reader to get the sense of each thread. This blog hopes to summarize the main points of the prior blog and add new material as well. I am delighted to welcome the participation of Doug Capra in this endeavor. He brings a large body of knowledge to this endeavor.We hope to be adding articles on a regular basis. We welcome other contributors for guest articles. If you'd like to contribute, please submit an article to us. Our email addresses can be found under the About the Moderators section. Comments and suggestions are also welcome here or on my prior blog.This blog will attempt to present and analyze all issues concerning patient privacy. The emphasis will be on direct patient issues rather than information transfer problems, that is HIPAA related issues, but all pertinent issues are welcome.

Fair use: Permission is freely given for limited quoting of the articles herein as long as the source is fully attributed and links given.

Disclaimer: No personal medical advice can be given. The fact that we post a comment does not imply that we either agree or disagree with it. We cannot control the factuality or content of any links we reference. Guest articles are the opinions of the author only. We do not necessarily agree with them and cannot vouch for their facts. . We're not lawyers and cannot give competent legal advice. Please see an attorney for legal advice.

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Book Recommendations

Those Who Work, Those Who Don't, a rural studyby Jennifer Sherman. My daughter's sociological study available thru Amazon.

My Angels Are Come by Art Stump. A documentation of privacy violations while undergoing Rx of prostate cancer. Can be ordered here.

Medical Rape, State Authorized German Perversion by Lars G Petersson. Documentation of mandatory humiliating German induction physicals. Can be ordered here thru Amazon.

AfterWe Die A book on death and burial, an exhaustive review of customs and laws. Available from Amazon.Protecting Your Health Privacy by Jacqueline Klosek can be ordered thru Amazon

Doctor Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care, by Steven Z. Kussin MD. A manual for patients on how to research your illnesses and choose physicians and hospitalsis available here.